title: Effect of occupation on risk of developing MS: an insurance cohort study.
abstract: OBJECTIVE
  The aim of this study was to estimate the occupational risks in relation to multiple sclerosis (MS). The immediate background for this research was our finding that there had been a high number of critical illness insurance claims by patients diagnosed with MS within the agricultural segment of a Danish pension fund.
  
  
  METHODS
  An open insurance cohort. All payouts for the critical illness insurance from 2002 to 2011 were continuously registered.
  
  
  METHODS
  PensionDanmark; one of Denmark's largest pension funds.
  
  
  METHODS
  PensionDanmark insures more than 300 000 members of the Danish Confederation of Trade Unions against critical illness. All members are insured, and all policies are identical. The total exposure is 3.3 million person-years.
  
  
  METHODS
  The incidence of MS.
  
  
  RESULTS
  During the 10-year period, 389 persons were diagnosed with MS. The crude incidence rate for men was 10.2/100 000; the corresponding figure for women was 16.1/100 000. We found signs of an overall effect of occupation on the risk of developing MS, and the high frequency found within the agricultural segment was attributed to dairy operators, who had an incidence of MS 2.0 times higher than the rest of the study's population (95% CI=1.2 to 3.0).
  
  
  CONCLUSIONS
  Our results indicate some occupational risk factors in MS, and this should be investigated further.
authors.affiliation: Department of Pharmacology, Bispebjerg Hospital, University of Copenhagen, Copenhagen, Denmark.
authors.forename: Henrik
authors.initials: H
authors.lastname: Horwitz
authors.forename: Birgitte
authors.initials: B
authors.lastname: Ahlgren
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Nærum
keywords: Epidemiology; Occupational & Industrial Medicine